İzolasyon ve karantinanın ruh sağlığı üzerine etkileri

Abstract

COVID-19 hastalığına yol açan SARS-CoV-2 (şiddetli akut solunum yolu sendromu koronavirüsü 2) virüsü yaklaşık 1 yıldır tüm dünya gündeminin en önemli konusudur. Koronavirüs pandemisi fiziksel, ruhsal, sosyal, ekonomik ve daha birçok yönden yıkıcı etkilere sebep olmuştur ve bu yıkıcı etkileri devam etmektedir. Çok eski tarihlerden bu yana salgınlardan korunmak için kullanılan karantina ve izolasyon yöntemleri ise pandeminin başından bu yana hayatımızın ayrılmaz bir parçası olup hâlâ salgınlardan korunmanın en etkin yöntemlerinden birisidir. Salgınlarda etkisi kanıtlanmış olan bu yöntem diğer yandan biyopsikososyal birçok olumsuz etkisini de beraberinde getirmektedir. Karantina dolayısıyla çalışamama ve kazancın azalması, aile içi şiddette artış, artmış çocuk ihmali/istismarı, alkol-madde kullanımında artış, damgalanma, sağlık çalışanları üzerindeki baskı ve iş yükünde artış, diğer fiziksel hastalıkların kontrolünün yapılamaması ve tedaviye ulaşamamaya bağlı kronik hastalıkların oluşturdukları sekeller, yaşlıların temel ihtiyaçlarını gidermelerindeki zorluklar ve sosyal geri çekilme kişilerde sıkıntı hissi, öfke, sinirlilik, kaygı gibi hayatın pek çok yönünü etkileyen önemli ruhsal etkilenime ve depresyon, anksiyete bozuklukları, travma sonrası stres bozukluğu gibi bir çok ruhsal bozukluğun ortaya çıkmasına sebep olmaktadır. Pandemi dönemlerinde ortaya çıkan ruhsal sorunların pandemi bittikten sonra da aylarca devam ettiği ve kişilerin işlevselliğini ve dolayısıyla toplumun işlevselliğini bozduğu geçmişte yapılan birçok çalışmada gösterilmiştir. Böylesine dramatik sonuçlara sebep olma riski taşıyan karantina ve izolasyonun başarılı bir şekilde yönetilmesi için yöneticilerin halka yönelik şeffaf bilgilendirme yapması, özel grupta yer alan kişilerin temel ihtiyaçlarının giderilmesi ve koruyucu ruh sağlığı hizmetlerinin güçlendirilmesi önem arz etmektedir.

Keywords

• Salgın
• pandemi
• Ruh sağlığı
• psikoloji
• ruhsal bozukluk

The psychological ımpact of quarantine and ısolation

Abstract

SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) pandemic which causes COVID-19 (Coronavirus disease 2019) has been the most important topic of the agenda all over the world for about 1 year. The pandemic has caused destructive effects in physical and mental health and also social, economic and many other aspects, and these destructive effects still continue. Quarantine and isolation methods, which have been used to protect against epidemics and pandemics since ancient times, have been an integral part of our lives since the beginning of the pandemic and are still one of the most effective methods of protection from epidemics and pandemics. This method, which has been proven to be effective, also brings many biopsychosocial negative effects along with it. Social withdrawal, being away from work and decrease in earnings, increase in domestic violence and child neglect / abuse, increase in alcohol-substance use, stigma, pressure and overload on healthcare workers, the sequelae of chronic diseases due to not having access to treatments, even difficulties in meeting basic needs due to quarantine cause significant psychological impacts such as distress, anger, irritability, anxiety, and many mental disorders such as depression, anxiety disorders, post-traumatic stress disorder during the pandemic. It has been shown in many past studies that the mental problems that occur during pandemic periods continue for months after the pandemic ends and disrupts the functionality of people and thus the functionality of the society. In order to successfully manage quarantine and isolation, which have the risk of causing such dramatic consequences, government officials should consider to provide transparent information to the public, to meet the basic needs of the people in the special group and to strengthen preventive mental health services.

Keywords

• Pandemic
• psychology
• mental health
• mental disorders

References

1. Kaynaklar 1. T.C. Sağlık Bakanlığı Covıd-19 Bilgilendirme Sayfası. Erişim yeri:. https://covid19.saglik.gov.tr/TR-66507/s.html. 22.01.2021 tarihinde erişilmiştir.
2. 2. Renaud K, van Schaik P, Irons A, Wilford S. 2020 UK Lockdown Cyber Narratives: the Secure, the Insecure and the Worrying. 11 June 2020. Access by: https://arxiv.org/abs/2006.06340. Access Date: 1 June 2021.
3. 3. Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020;395(10227):912-920. doi:10.1016/S0140-6736(20)30460-8.
4. 4. Jeong H, Yim HW, Song YJ, et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health. 2016;38: e2016048. doi:10.4178/epih.e2016048.
5. 5. Caleo G, Duncombe J, Jephcott F, et al. The factors affecting household transmission dynamics and community compliance with Ebola control measures: A mixed-methods study in a rural village in Sierra Leone. BMC Public Health. 2018; 18: 1-13. doi:10.1186/s12889-018-5158-6.
6. 6. Bai YM, Lin CC, Lin CY, Chen JY, Chue CM, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004; 55(9): 1055-1057. doi:10.1176/appi.ps.55.9.1055.
7. 7. Braunack-Mayer A, Tooher R, Collins JE, Street JM, Marshall H. Understanding the school community’s response to school closures during the H1N1 2009 influenza pandemic. BMC Public Health. 2013;13(1):1-5. doi:10.1186/1471-2458-13-344.
8. 8. Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008;136 (7): 997-1007. doi:10.1017/S0950268807009156.

9. 9. Benke C, Autenrieth LK, Asselmann E, Pané-Farré CA. Lockdown, quarantine measures, and social distancing: Associations with depression, anxiety and distress at the beginning of the COVID-19 pandemic among adults from Germany. Psychiatry Res. 2020;293: 113462. doi:10.1016/j.psychres.2020.113462.
10. 10. Rossi R, Socci V, Talevi D, et al. COVID-19 Pandemic and Lockdown Measures Impact on Mental Health Among the General Population in Italy. Front Psychiatry. 2020;11: 790. doi:10.3389/fpsyt.2020.00790.
11. 11. Best LA, Law MA, Roach S, Wilbiks JMP. The Psychological Impact of COVID-19 in Canada: Effects of Social Isolation During the Initial Response. Can Psychol. 2020 Page unidentified. doi:10.1037/cap0000254.
12. 12. Gualano MR, Lo Moro G, Voglino G, Bert F, Siliquini R. Effects of COVID-19 lockdown on mental health and sleep disturbances in Italy. Int J Environ Res Public Health. 2020: 17(13): 4779. doi:10.3390/ijerph17134779.
13. 13. 12. Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912-920. doi:10.1016/S0140-6736(20)30460-8.
14. 14. Rona RJ, Fear NT, Hull L, et al. Mental health consequences of overstretch in the UK armed forces: First phase of a cohort study. Br Med J. 2007; 335(7620): 603. doi:10.1136/bmj.39274.585752.BE.
15. 15. Xin M, Luo S, She R, et al. Negative cognitive and psychological correlates of mandatory quarantine during the initial COVID-19 outbreak in China. Am Psychol. 2020;75(5):607-617. doi:10.1037/amp0000692.
16. 16. Altın Z. Covid-19 Pandemisinde Yaşlılar. Tepecik Eğit ve Araşt Hast Derg. 2020;30:49-57. doi:10.5222/terh.2020.93723.
17. 17. Yıldırım H, Işık K AR. No TitleThe effect of anxiety levels of elderly people in quarantine on depression during covid-19 pandemic. Social Work in Public Health 2021; 36(2):194-204. doi:10.1080/19371918.2020.1868372.
18. 18. Yang Y, Li W, Zhang Q, Zhang L, Cheung T, Xiang YT. Mental health services for older adults in China during the COVID-19 outbreak. The Lancet Psychiatry. The Lancet Psychiatry, 2020; 7(4): 19. doi:10.1016/S2215-0366(20)30079-1.
19. 19. Meng H, Xu Y, Dai J, Zhang Y, Liu B, Yang H. The Psychological effect of COVID-19 on the Elderly in China. Psychiatry Res. 2020;289:112983. doi: 10.1016/j.psychres.2020.112983.
20. 20. Santini ZI, Jose PE, York Cornwell E, et al. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis. Lancet Public Heal. 2020;5:62-70. doi:10.1016/S2468-2667(19)30230-0.
21. 21. Vefa Sosyal Destek Grupları, 65 Yaş ve Üstü ile Kronik Rahatsızlığı Olanlara Sokağa Çıkma Yasağı Genelgesi. Erişim Yeri: https://www.icisleri.gov.tr/65-yas-ve-ustu-ile-kronik-rahatsizligi-olanlara-sokaga-cikma-yasagi-genelgesi Erişim tarihi: 23.02.2021.
22. 22. Norredam M, Nellums L, Nielsen RS, Byberg S, Petersen JH. Incidence of psychiatric disorders among accompanied and unaccompanied asylum-seeking children in Denmark: a nation-wide register-based cohort study. Eur Child Adolesc Psychiatry. 2018: 7(4):439-446. doi:10.1007/s00787-018-1122-3.
23. 23. Sprang G, Silman M. Posttraumatic stress disorder in parents and youth after health-related disasters. Disaster Med Public Health Prep. 2013; 7(1):105-10. doi:10.1017/dmp.2013.22.
24. 24. Santavirta T, Santavirta N, Betancourt TS, Gilman SE. Long term mental health outcomes of Finnish children evacuated to Swedish families during the second world war and their non-evacuated siblings: Cohort study. BMJ. 2015;15 (350):7753. doi:10.1136/bmj.g7753.
25. 25. Abel KM, Heuvelman HP, Jörgensen L, et al. Severe bereavement stress during the prenatal and childhood periods and risk of psychosis in later life: Population based cohort study. BMJ. 2014;348:7679. doi:10.1136/bmj.f7679.
26. 26. Taylor MR, Agho KE, Stevens GJ, Raphael B. Factors influencing psychological distress during a disease epidemic: Data from Australia’s first outbreak of equine influenza. BMC Public Health. 2008 8:347. doi:10.1186/1471-2458-8-347.
27. 27. Wu P, Liu X, Fang Y, et al. Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak. Alcohol Alcohol. 2008;43(6): 706–712. doi:10.1093/alcalc/agn073.
28. 28. Türkiye Psikiyatri Derneği Sağlık Çalışanları Ruhsal Destek Hattı. https://www.psikiyatri.org.tr/2207/turkiye-psikiyatri-dernegi-saglik-calisanlari-ruhsal-destek-hatti. Erişim Tarihi: 21.01.2021.
29. 29. Hao F, Tan W, Jiang L, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain Behav Immun. 2020;87:100-106. doi:10.1016/j.bbi.2020.04.069.
30. 30. Muruganandam P, Neelamegam S, Menon V, Alexander J, Chaturvedi SK. COVID-19 and Severe Mental Illness: Impact on patients and its relation with their awareness about COVID-19. Psychiatry Res. 2020;291:113265. doi:10.1016/j.psychres.2020.113265.
31. 31. Moffitt P, Aujla W, Giesbrecht CJ, Grant I, Straatman AL. Intimate Partner Violence and COVID-19 in Rural, Remote, and Northern Canada: Relationship, Vulnerability and Risk. J Fam Violence. 2020: 35(6): 1-12. doi:10.1007/s10896-020-00212-x.
32. 32. Pandemics and Violence Against Women and Children | Center For Global Development. Erişim Yeri: https://www.cgdev.org/publication/pandemics-and-violence-against-women-and-children. Access date: 21 Ocak 2021.
33. 33. Richards TN, Tillyer MS, Wright EM. Intimate partner violence and the overlap of perpetration and victimization: Considering the influence of physical, sexual, and emotional abuse in childhood. Child Abus Negl. 2017: 67:240-248. doi:10.1016/j.chiabu.2017.02.037.
34. 34. Duncan TK, Weaver JL, Zakrison TL, et al. Domestic Violence and Safe Storage of Firearms in the COVID-19 Era. Ann Surg. 2020;272(2):e55-e57. doi:10.1097/SLA.0000000000004088.
35. 35. Lakhan R, Agrawal A, Sharma M. Prevalence of Depression, Anxiety, and Stress during COVID-19 Pandemic. J Neurosci Rural Pract. 2020;11(4):519-525. doi:10.1055/s-0040-1716442.
36. 36. Organization WH. COVID-19 and Violence against Women What the Health Sector/System Can Do. Erişim Yeri: https://www.womensaid.org.uk/the-impact-of-covid-19-on-women-and-children-experiencing-domestic-abuse-and-the-. Access date: 21 Ocak 2021.
37. 37. Wagers S, Radatz DL. Emerging Treatment Models and Programs in Intimate Partner Violence Treatment: An Introduction. Partner Abuse. 2020: 11(3): 202-227. doi:10.1891/PA-2020-0015.
38. 38. Plan-International.Org/Ebolareport Young Lives on Lockdown: The Impact of Ebola on Children and Communities in Liberia Interim Report Erişim Yeri: https://resourcecentre.savethechildren.net/node/8708/pdf/liberialockdown-executivesummary_0.pdf Access date: 21 Ocak 2021.
39. 39. Kübler-Ross, E., & Kessler, D. On grief and grieving: Finding the meaning of grief through the five stages of loss. New York, NY: Scribner. 2005.
40. 40. Monteith LL, Holliday R, Brown TL, Brenner LA, Mohatt N V. Preventing Suicide in Rural Communities During the COVID-19 Pandemic. J Rural Heal. 2021: In press. doi:10.1111/jrh.12448.
41. 41. Kawohl W, Nordt C. COVID-19, unemployment, and suicide. The Lancet Psychiatry. 2020; 7 (5): 389-390. doi:10.1016/S2215-0366(20)30141-3.
42. 42. Ammerman BA, Burke TA, Jacobucci R, McClure K. Preliminary investigation of the association between COVID-19 and suicidal thoughts and behaviors in the U.S. J Psychiatr Res. 2021:15;134:32-38. doi:10.1016/j.jpsychires.2020.12.037.
43. 43. Huang JZ, Han MF, Luo TD, Ren AK, Zhou XP. Mental health survey of medical staff in a tertiary infectious disease hospital for COVID-19. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020: 20;38(3):192-195. doi:10.3760/cma.j.cn121094-20200219-00063.
44. 44. Corrigan PW, Druss BG, Perlick DA. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interes Suppl. 2014: 15(2):37-70. doi:10.1177/1529100614531398.
45. 45. Wilson JM, Lee J, Fitzgerald HN, Oosterhoff B, Sevi B, Shook NJ. Job Insecurity and Financial Concern During the COVID-19 Pandemic Are Associated With Worse Mental Health. J Occup Environ Med. 2020;62(9):686-691. doi:10.1097/JOM.0000000000001962.
46. 46. Desclaux A, Badji D, Ndione AG, Sow K. Accepted monitoring or endured quarantine? Ebola contacts’ perceptions in Senegal. Soc Sci Med. 2017:78:38-45. doi:10.1016/j.socscimed.2017.02.009.
47. 47. Nordt C, Warnke I, Seifritz E, Kawohl W. Modelling suicide and unemployment: A longitudinal analysis covering 63 countries, 2000-11. The Lancet Psychiatry. 2015:2(3):239-45. doi:10.1016/S2215-0366(14)00118-7.
48. 48. Bhuiyan AKMI, Sakib N, Pakpour AH, Griffiths MD, Mamun MA. COVID-19-Related Suicides in Bangladesh Due to Lockdown and Economic Factors: Case Study Evidence from Media Reports. Int J Ment Health Addict. 2020: 15 :1–6. doi:10.1007/s11469-020-00307-y.
49. 49. Desclaux A, Badji D, Ndione AG, Sow K. Accepted monitoring or endured quarantine? Ebola contacts’ perceptions in Senegal. Soc Sci Med. 2017:78:38-45. doi:10.1016/j.socscimed.2017.02.009.
50. 50. Nordt C, Warnke I, Seifritz E, Kawohl W. Modelling suicide and unemployment: A longitudinal analysis covering 63 countries, 2000-11. The Lancet Psychiatry. 2015:2(3):239-45. doi:10.1016/S2215-0366(14)00118-7.
51. 51. Bhuiyan AKMI, Sakib N, Pakpour AH, Griffiths MD, Mamun MA. COVID-19-Related Suicides in Bangladesh Due to Lockdown and Economic Factors: Case Study Evidence from Media Reports. Int J Ment Health Addict. 2020: 15 :1–6. doi:10.1007/s11469-020-00307-y.